Tropical Travel Trouble 010 Fever, Arthralgia and Rash
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
aka Tropical Travel Trouble 010
Peer Reviewer: Dr Jennifer Ho, ID physician QLD, Australia
You are an ED doc working in Perth over schoolies week. An 18 yo man comes into ED complaining of fever, rash a “cracking headache” and body aches. He has just hopped off the plane from Bali where he spent the last 2 weeks partying, boozing and running amok. He got bitten by “loads” of mosquitoes because he forgot to take insect repellent.
On examination he looks miserable, temp 39.8 °C, HR 115, BP 108/60, blanching maculopapular rash over his face, thorax, and flexor surfaces.
Questions:
Q1. What could this be?
Answer and interpretation
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Acute febrile illness in the returned traveller can be a number of diagnoses (not exhaustive):
Bacterial: strep throat, leptospirosis, toxic shock syndrome, rickettsia, typhoid, Melioidosis and meningitis.
Viral: Fifth disease, enterovirus, scarlet fever, hepatitis, zika, Chikungunya, Roseola, EBV, HIV seroconversion, West Nile virus, influenza, adenovirus, measles and Rubella.
Parasitic: malaria
Non infectious: ITP, Acute leukaemia, drug reaction and Kawasaki in the young.
Due to fact this is a tropical post the most likely culprit is an arbovirus (any disease transmitted by arthropo...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Amanda McConnell Tags: Clinical Cases Tropical Medicine arthralgia dengue fever rash Source Type: blogs
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